Auditory Processing Disorder Group Research Articles

Altered structural connectome of children with auditory processing disorder: a diffusion MRI study.

Auditory processing disorder (APD) is a listening impairment that some school-aged children may experience despite having normal peripheral hearing. Recent resting-state functional magnetic resonance imaging (MRI) has revealed an alteration in regional functional brain topology in children with APD. However, little is known about the structural organization in APD. We used diffusion MRI data to investigate the structural connectome of 58 children from 8 to 14years old diagnosed with APD (n = 29) and children without hearing complaints (healthy controls, HC; n = 29). We investigated the rich-club organization and structural connection differences between groups. The APD group showed similar rich-club organization and edge-wise connection compared with the HC group. However, at the regional level, we observed increased average path length (APL) and betweenness centrality in the right inferior parietal lobule and inferior precentral gyrus, respectively, in the APD group. Only HCs demonstrated a positive association between APL and the listening-in-spatialized-noise-sentences task in the left orbital gyrus. In line with previous findings, the current results provide evidence for altered structural networks at the regional level in the APD group, suggesting the involvement of multimodal deficits and a role for structure-function alteration in the listening difficulties of children with APD.

Avaliação das funções cognitivas em idosos com e sem alterações no processamento auditivo central

ABSTRACT Purpose Evaluate and compare the performance of cognitive functions between elderly with and without auditory processing disorders. Methods Twenty-eight healthy elderly (14 Control group and 14 Auditory Processing Disorder group - APD group) participated in the study. All elderly were submitted to (central) auditory processing evaluation, P300 event-related potential and brief cognitive battery (BCB). In the comparison between subjects, the Mann-Whitney test was applied and in the intra-subjects comparison, the Wilcoxon signed rank test was used. To verify if there was an association between the performance of the PAC and the cognitive variables, Spearman's correlation was used. Results There were no statistically significant differences between the Control and APD groups for the cognitive abilities assessed by BCB, as well as for the P300 cognitive potential variables. Conclusion Elderly with auditory processing disorders do not seem to show greater cognitive difficulties compared to elderly of the same age group without auditory processing disorders, exception of the clock drawing test, whose task involves multiple cognitive functions, including visuospatial processing, executive function, semantic memory, and planning.

Evaluation of cognitive functions in the elderly with and without central auditory processing disorder.

Evaluate and compare the performance of cognitive functions between elderly with and without auditory processing disorders. Twenty-eight healthy elderly (14 Control group and 14 Auditory Processing Disorder group - APD group) participated in the study. All elderly were submitted to (central) auditory processing evaluation, P300 event-related potential and brief cognitive battery (BCB). In the comparison between subjects, the Mann-Whitney test was applied and in the intra-subjects comparison, the Wilcoxon signed rank test was used. To verify if there was an association between the performance of the PAC and the cognitive variables, Spearman's correlation was used. There were no statistically significant differences between the Control and APD groups for the cognitive abilities assessed by BCB, as well as for the P300 cognitive potential variables. Elderly with auditory processing disorders do not seem to show greater cognitive difficulties compared to elderly of the same age group without auditory processing disorders, exception of the clock drawing test, whose task involves multiple cognitive functions, including visuospatial processing, executive function, semantic memory, and planning.

Subcortical and Cortical Electrophysiological Measures in Children With Speech-in-Noise Deficits Associated With Auditory Processing Disorders.

The aim of this study was to analyze the subcortical and cortical auditory evoked potentials for speech stimuli in children with speech-in-noise (SIN) deficits associated with auditory processing disorder (APD) without any reading or language deficits. The study included 20 children in the age range of 9-13 years. Ten children were recruited to the APD group; they had below-normal scores on the speech-perception-in-noise test and were diagnosed as having APD. The remaining 10 were typically developing (TD) children and were recruited to the TD group. Speech-evoked subcortical (brainstem) and cortical (auditory late latency) responses were recorded and compared across both groups. The results showed a statistically significant reduction in the amplitudes of the subcortical potentials (both for stimulus in quiet and in noise) and the magnitudes of the spectral components (fundamental frequency and the second formant) in children with SIN deficits in the APD group compared to the TD group. In addition, the APD group displayed enhanced amplitudes of the cortical potentials compared to the TD group. Children with SIN deficits associated with APD exhibited impaired coding/processing of the auditory information at the level of the brainstem and the auditory cortex. https://doi.org/10.23641/asha.21357735.

Altered brain network topology in children with auditory processing disorder: A resting-state multi-echo fMRI study

Children with auditory processing disorder (APD) experience hearing difficulties, particularly in the presence of competing sounds, despite having normal audiograms. There is considerable debate on whether APD symptoms originate from bottom-up (e.g., auditory sensory processing) and/or top-down processing (e.g., cognitive, language, memory). A related issue is that little is known about whether functional brain network topology is altered in APD. Therefore, we used resting-state functional magnetic resonance imaging data to investigate the functional brain network organization of 57 children from 8 to 14 years old, diagnosed with APD (n = 28) and without hearing difficulties (healthy control, HC; n = 29). We applied complex network analysis using graph theory to assess the whole-brain integration and segregation of functional networks and brain hub architecture. Our results showed children with APD and HC have similar global network properties –i.e., an average of all brain regions– and modular organization. Still, the APD group showed different hub architecture in default mode-ventral attention, somatomotor and frontoparietal-dorsal attention modules. At the nodal level –i.e., single-brain regions–, we observed decreased participation coefficient (PC – a measure quantifying the diversity of between-network connectivity) in auditory cortical regions in APD, including bilateral superior temporal gyrus and left middle temporal gyrus. Beyond auditory regions, PC was also decreased in APD in bilateral posterior temporo-occipital cortices, left intraparietal sulcus, and right posterior insular cortex. Correlation analysis suggested a positive association between PC in the left parahippocampal gyrus and the listening-in-spatialized-noise -sentences task where APD children were engaged in auditory perception. In conclusion, our findings provide evidence of altered brain network organization in children with APD, specific to auditory networks, and shed new light on the neural systems underlying children's listening difficulties.

Validity of the Multiple Auditory Processing Assessment-2: A Test of Auditory Processing Disorder.

Purpose A normative study using the Multiple Auditory Processing Assessment-2 (MAPA-2; Schow et al., 2018) was recently completed. With access to these data, the authors extend that work and support a definite construct for auditory processing disorder (APD). The goal here is to examine MAPA-2 reliability and validity (construct, content, and concurrent). Evidence for the APD construct is further buttressed by measures of sensitivity and specificity. Results of MAPA-2 testing on children diagnosed with learning disability (LD), attention-deficit/hyperactivity disorder (ADHD), and specific language impairment (SLI) are included. Method Normative data (previously published as the MAPA-2) allowing derivation of these findings included a representative sample of 748 children (53% girls) ages 7-14 years tested by 54 speech-language pathologists and audiologists in 27 U.S. states. The authors examined diagnostic accuracy based on the American Speech-Language-Hearing Association (2005) criteria (index test) for confirmed cases of APD. The index was also used to identify listening problems for three other diagnostic categories (LD, ADHD, and SLI). Validated questionnaire responses from parents and school personnel allowed incorporation of functional measures widely supported in APD diagnosis but unavailable with other normative and sensitivity/specificity studies. Results Reliability and validity were both satisfactory, and diagnostic accuracy for an APD group of 18 (28% female) compared to the remaining typical group of 625 yielded 89% sensitivity and 82% specificity. The remaining three groups (LD, ADHD, and SLI), where comorbidity was expected to be about 50%, had APD-type listening problems with a prevalence ranging from 52% to 65%. Conclusions Current results provide important evidence for the construct of APD. The MAPA-2 can be administered by an audiologist or speech-language pathologist. A similar diagnostic protocol in Australia yielded positive therapeutic gains. Further study is encouraged to determine if the present positive findings will be found in future research.

Deficits in Auditory Rhythm Perception in Children With Auditory Processing Disorder Are Unrelated to Attention.

Auditory processing disorder (APD) is defined as a specific deficit in the processing of auditory information along the central auditory nervous system, including bottom-up and top-down neural connectivity. Even though music comprises a big part of audition, testing music perception in APD population has not yet gained wide attention in research. This work tests the hypothesis that deficits in rhythm perception occur in a group of subjects with APD. The primary focus of this study is to measure perception of a simple auditory rhythm, i.e., short isochronous sequences of beats, in APD children and to compare their performance to age-matched normal controls. The secondary question is to study the relationship between cognition and auditory processing of rhythm perception. We tested 39 APD children and 25 control children aged between 6 and 12 years via (a) clinical APD tests, including a monaural speech in noise test, (b) isochrony task, a test measuring the detection of small deviations from perfect isochrony in a isochronous beats sequence, and (c) two cognitive tests (auditory memory and auditory attention). APD children scored worse in isochrony task compared to the age-matched control group. In the APD group, neither measure of cognition (attention nor memory) correlated with performance in isochrony task. Left (but not right) speech in noise performance correlated with performance in isochrony task. In the control group a large correlation (r = −0.701, p = 0.001) was observed between isochrony task and attention, but not with memory. The results demonstrate a deficit in the perception of regularly timed sequences in APD that is relevant to the perception of speech in noise, a ubiquitous complaint in this condition. Our results suggest (a) the existence of a non-attention related rhythm perception deficit in APD children and (b) differential effects of attention on task performance in normal vs. APD children. The potential beneficial use of music/rhythm training for rehabilitation purposes in APD children would need to be explored.

Assessment of the efferent auditory system in children with suspected auditory processing disorder: the Middle ear muscle reflex and contralateral inhibition of OAEs

Objective: To determine whether children aged 7 to 12 years with listening difficulties show objective evidence for efferent auditory function based on measurements of medial olivo-cochlear and middle ear muscle reflexes.Design: Click-evoked otoacoustic emissions recorded with and without contralateral broadband noise and ipsilateral and contralateral tonal (1000, 2000 Hz) middle ear muscle reflex thresholds were examined.Study sample: 29 children diagnosed with suspected auditory processing disorder (APD) and a control group of 34 typically developing children participated in this study.Results: Children with suspected APD had poorer performance on auditory processing tests than the control group. Middle ear muscle reflex thresholds were significantly higher at 2000 Hz in the suspected APD group for contralateral stimulation. MOC inhibition effects did not differ between APD and control groups.Conclusions: This research supports earlier studies showing altered acoustic reflexes in children with APD. No group differences were found for the MOC reflex measures, consistent with some earlier studies in children with APD.

Speech Processing to Improve the Perception of Speech in Background Noise for Children With Auditory Processing Disorder and Typically Developing Peers.

Auditory processing disorder (APD) may be diagnosed when a child has listening difficulties but has normal audiometric thresholds. For adults with normal hearing and with mild-to-moderate hearing impairment, an algorithm called spectral shaping with dynamic range compression (SSDRC) has been shown to increase the intelligibility of speech when background noise is added after the processing. Here, we assessed the effect of such processing using 8 children with APD and 10 age-matched control children. The loudness of the processed and unprocessed sentences was matched using a loudness model. The task was to repeat back sentences produced by a female speaker when presented with either speech-shaped noise (SSN) or a male competing speaker (CS) at two signal-to-background ratios (SBRs). Speech identification was significantly better with SSDRC processing than without, for both groups. The benefit of SSDRC processing was greater for the SSN than for the CS background. For the SSN, scores were similar for the two groups at both SBRs. For the CS, the APD group performed significantly more poorly than the control group. The overall improvement produced by SSDRC processing could be useful for enhancing communication in a classroom where the teacher’s voice is broadcast using a wireless system.

Middle ear muscle reflex in children with auditory processing and/or attention deficit/hyperactivity disorders

Previous studies suggest abnormal auditory efferent systems in children with Auditory Processing Disorder (APD) and children with Attention-Deficit/Hyperactivity Disorder (ADHD). The current study examined the middle ear muscle reflex (MEMR) of three groups of children. The APD group consisted of 32 children with auditory processing deficits and the ADHD group consisted of 50 children. The children with ADHD were either taking ADHD-related medication (n = 31) or not taking such medication (n = 19). All subjects were selected from an existing database. Ipsilateral MEMR responses at 0.5, 1, 2, and 4 kHz in each ear were categorized as normal or abnormal (defined as any response over 90dB HL, or no response). Contingency table analyses and corresponding chi-square tests were used to compare the proportion of abnormal MEMR responses between groups and ears. We found no significant difference between APD and ADHD groups. The children with APD and children with ADHD medication showed no significant ear difference (ps > 0.5), whereas children without ADHD medication exhibited a marginally significant difference between the left and right ear (p = 0.044). The results suggest abnormal asymmetry in auditory efferent pathways in ADHD. Further studies should include contralateral pathways to further evaluate asymmetrical patterns in these groups.

A long-term follow-up of children and adolescents referred for assessment of auditory processing disorder

Objective: This study investigated whether young adults (between 18 and 30 years at the time of the project) who were assessed for auditory processing disorder (APD) in childhood (between 7 and 16 years) experience persistence of listening and communication difficulties. Design: Participants completed a mixed methods questionnaire focusing on common areas of complaint in APD and two open-ended questions exploring participants’ past and present experiences with listening and communication difficulties. Study sample: Ninety-seven of the 722 potential participants returned completed questionnaires, of whom 66 had been diagnosed with APD (APD group) at the time of their auditory processing assessment and 31 had not met diagnostic criteria (NAPD group) at that time. Results: Substantial commonality was noted in the reported listening and communication difficulties between the APD and NAPD participants. Volunteered comments aggregated into four major content themes which included: listening and communication difficulties; participants’ sense of self; change; and participation. Members of the APD group reported greater communication difficulty than NAPD group members, irrespective of environmental listening conditions. Conclusions: Young adults with a prior referral for, and in some cases a diagnosis of, APD as children continue to experience auditory processing difficulties across a range of daily situations.

Baseline neurophysiological noise levels in children with auditory processing disorder

The current study examined the baseline neurophysiological responses between children with auditory processing disorder (APD) and the control group. Auditory event related potentials were recorded in 23 children with APD (ages 7–12 years, mean age = 8.9 years) and 25 age-matched control children in response to a /da/ presented to each ear separately (right and left ear conditions). A no-sound condition was recorded as well. Baseline neurophysiological activity was measured as the root mean square amplitude of the 100 ms pre-stimulus period. Preliminary analysis of data from 19 children with APD and 13 controls indicated that the APD group showed significantly greater pre-stimulus amplitude than the control group in the left ear condition, F(1, 30) = 4.415, p = 0.044, but we did not find significant group differences in the no-sound and right ear conditions, F(1, 30) = 2.237, p = 0.15 and F(1, 30) = 0.088, p = 0.77, respectively. The results suggest that children with APD may need a longer time period to return to a resting state than control children when the left ear is stimulated. Hence, these results may indicate asymmetrical neural activities of the auditory pathways in APD.

Sensitivity, specificity and efficiency of speech-evoked ABR

We determined the sensitivity, specificity and efficiency of speech-evoked Auditory Brainstem Response (ABR) as a diagnostic support for Auditory Processing Disorder (APD) and specific language impairment (SLI). Speech-evoked ABRs were elicited using the five-formant syllable/da/. The waveforms V, A, C, D, E, F, and O of all groups were analyzed. The sensitivity and specificity were calculated, and receiver operating characteristic analyses were performed to determine the optimum cut-off. Seventy-five children who were native speakers of Brazilian-Portuguese participated. The participants included 25 children with APD, 25 children with SLI and 25 with typical development. Statistical analysis demonstrated a cut-off for latency values of 6.48, 7.51, 17.82, 22.33, 30.79, 39.54 and 48.00 for V, A, C, D, E, F, and O waves, respectively. The A wave exhibited superior balance for the APD group. For the SLI group, the A, D and O waves exhibited the best balance. Furthermore, when analyzing the APD and SLI groups separately, better sensitivity values were observed for the SLI group than the APD group. Speech-evoked ABR is a useful test to identify auditory processing disorders and language impairment. Furthermore, this study represented an important step forward in establishing the clinical utility of speech-evoked ABR in Brazilian Portuguese-speaking children.

Association between language development and auditory processing disorders

IntroductionIt is crucial to understand the complex processing of acoustic stimuli along the auditory pathway; comprehension of this complex processing can facilitate our understanding of the processes that underlie normal and altered human communication. AimTo investigate the performance and lateralization effects on auditory processing assessment in children with specific language impairment (SLI), relating these findings to those obtained in children with auditory processing disorder (APD) and typical development (TD). Material and methodsProspective study. Seventy-five children, aged 6-12 years, were separated in three groups: 25 children with SLI, 25 children with APD, and 25 children with TD. All went through the following tests: speech-in-noise test, Dichotic Digit test and Pitch Pattern Sequencing test. ResultsThe effects of lateralization were observed only in the SLI group, with the left ear presenting much lower scores than those presented to the right ear. The inter-group analysis has shown that in all tests children from APD and SLI groups had significantly poorer performance compared to TD group. Moreover, SLI group presented worse results than APD group. ConclusionThis study has shown, in children with SLI, an inefficient processing of essential sound components and an effect of lateralization. These findings may indicate that neural processes (required for auditory processing) are different between auditory processing and speech disorders.

Psychosocial Status of Children with Auditory Processing Disorder

Children with hearing loss often exhibit reduced psychosocial status compared to children with normal hearing. It is reasonable to assume that psychosocial function may also be affected in children diagnosed with auditory processing disorder (APD). However, there are no published studies specifically addressing the psychosocial health of children with APD. This investigation examined relationships between APD and psychosocial status, with an aim to examine nonauditory factors that may influence quality of life of children diagnosed with APD. A two-matched group design was employed. Participants and their mothers completed appropriate versions of the Dartmouth Primary Care Cooperative Information Project Charts for Adolescents (COOP-A), the Behavioral Assessment System for Children, Second Edition (BASC-2), and the Social Skills Rating System (SSRS). Participants consisted of 19 children (aged 9.5-17.8 yr; mean = 11.9) diagnosed with APD and 20 gender- and age-matched (mean = 12.8 yr) children with no evidence of APD by history or audiological assessment. Primary caretakers (mothers) of the participants also completed psychosocial questionnaires according to their perception of their participating child's function. Data were collected at a single visit, following APD diagnosis. Data from each questionnaire were analyzed using appropriate statistical methods for two-group comparisons. Analysis of child reports revealed significantly greater psychosocial difficulty in the APD group on subscales of the COOP-A and BASC-2. Increased problems in the APD group were also reported by parents on subscales of the COOP-A, BASC-2, and SSRS. Eta-squared values for all significant findings indicated moderate to large effect sizes, suggesting findings may be generalized to other children in this age group. No between-group differences were found on any subscale for APD children with or without a confirmed or suspected language disorder. We found that children with APD exhibit increased psychosocial difficulty in several areas compared to children without APD.

Psychometric Evaluation of Children With Auditory Processing Disorder (APD): Comparison With Normal-Hearing and Clinical Non-APD Groups

To investigate the clinical utility of the Children's Auditory Processing Performance Scale (CHAPPS; Smoski, Brunt, & Tannahill, 1992) to evaluate listening ability in 12-year-old children referred for auditory processing assessment. This was a prospective case control study of 97 children (age range = 11;4 [years;months] to 12;7). Auditory processing disorder (APD) was diagnosed based on findings of deficits on at least 1 nonverbal test and on at least 2 tests of an auditory processing test battery. Clinically referred children were grouped as APD (n = 38) or non-APD (n = 20). The study found that (a) the APD group performed lower than the non-APD group on the Quiet, Ideal, Memory (p < .0001), and Attention (p < .05) subscales of the CHAPPS; (b) the non-APD group performed lower than the group with normal hearing on the Noise, Multiple Inputs, and Attention subscales (p < .0001); and (c) there were significant moderate-to-strong correlations (Spearman's ρ > .04) between Dichotic Digits, Duration Pattern tests, and the CHAPPS Attention, Memory, and total scores. The CHAPPS may be a clinically useful tool to evaluate listening ability in 12-year-old children suspected of having APD. Restricting use of the CHAPPS to older children may help address its limitations as reported by other studies.

Random Gap Detection Test (RGDT) performance of individuals with central auditory processing disorders from 5 to 25 years of age

Objective The aim of the present study was to assess the auditory temporal resolution ability in individuals with central auditory processing disorders, to examine the maturation effect and to investigate the relationship between the performance on a temporal resolution test with the performance on other central auditory tests. Methods Participants were divided in two groups: 131 with Central Auditory Processing Disorder and 94 with normal auditory processing. They had pure-tone air-conduction thresholds no poorer than 15 dB HL bilaterally, normal admittance measures and presence of acoustic reflexes. Also, they were assessed with a central auditory test battery. Participants who failed at least one or more tests were included in the Central Auditory Processing Disorder group and those in the control group obtained normal performance on all tests. Following the auditory processing assessment, the Random Gap Detection Test was administered to the participants. A three-way ANOVA was performed. Correlation analyses were also done between the four Random Gap Detection Test subtests data as well as between Random Gap Detection Test data and the other auditory processing test results. Results There was a significant difference between the age-group performances in children with and without Central Auditory Processing Disorder. Also, 48% of children with Central Auditory Processing Disorder failed the Random Gap Detection Test and the percentage decreased as a function of age. The highest percentage (86%) was found in the 5–6 year-old children. Furthermore, results revealed a strong significant correlation between the four Random Gap Detection Test subtests. There was a modest correlation between the Random Gap Detection Test results and the dichotic listening tests. No significant correlation was observed between the Random Gap Detection Test data and the results of the other tests in the battery. Conclusion Random Gap Detection Test should not be administered to children younger than 7 years old because other reduced capacities might influence their performance. Also, Random Gap Detection Test assesses a specific auditory ability, different than the one evaluated with the other auditory tests. Finally, it is suggested to test individuals at only one frequency of the Random Gap Detection Test because results provide similar information than when assessing them on all subtests.

The Utility of Visual Analogs of Central Auditory Tests in the Differential Diagnosis of (Central) Auditory Processing Disorder and Attention Deficit Hyperactivity Disorder

Cacace and McFarland (2005) have suggested that the addition of cross-modal analogs will improve the diagnostic specificity of (C)APD (central auditory processing disorder) by ensuring that deficits observed are due to the auditory nature of the stimulus and not to supra-modal or other confounds. Others (e.g., Musiek et al, 2005) have expressed concern about the use of such analogs in diagnosing (C)APD given the uncertainty as to the degree to which cross-modal measures truly are analogous and emphasize the nonmodularity of the CANs (central auditory nervous system) and its function, which precludes modality specificity of (C)APD. To date, no studies have examined the clinical utility of cross-modal (e.g., visual) analogs of central auditory tests in the differential diagnosis of (C)APD. This study investigated performance of children diagnosed with (C)APD, children diagnosed with ADHD (attention deficit hyperactivity disorder), and typically developing children on three diagnostic tests of central auditory function and their corresponding visual analogs. The study sought to determine whether deficits observed in the (C)APD group were restricted to the auditory modality and the degree to which the addition of visual analogs aids in the ability to differentiate among groups. An experimental repeated measures design was employed. Participants consisted of three groups of right-handed children (normal control, n=10; ADHD, n=10; (C)APD, n=7) with normal and symmetrical hearing sensitivity, normal or corrected-to-normal visual acuity, and no family or personal history of disorders unrelated to their primary diagnosis. Participants in Groups 2 and 3 met current diagnostic criteria for ADHD and (C)APD. Visual analogs of three tests in common clinical use for the diagnosis of (C)APD were used (Dichotic Digits [Musiek, 1983]; Frequency Patterns [Pinheiro and Ptacek, 1971]; and Duration Patterns [Pinheiro and Musiek, 1985]). Participants underwent two 1 hr test sessions separated by at least 1 wk. Order of sessions (auditory, visual) and tests within each session were counterbalanced across participants. ANCOVAs (analyses of covariance) were used to examine effects of group, modality, and laterality (Dichotic/Dichoptic Digits) or response condition (auditory and visual patterning). In addition, planned univariate ANCOVAs were used to examine effects of group on intratest comparison measures (REA, HLD [Humming-Labeling Differential]). Children with both ADHD and (C)APD performed more poorly overall than typically developing children on all tasks, with the (C)APD group exhibiting the poorest performance on the auditory and visual patterns tests but the ADHD and (C)APD group performing similarly on the Dichotic/Dichoptic Digits task. However, each of the auditory and visual intratest comparison measures, when taken individually, was able to distinguish the (C)APD group from both the normal control and ADHD groups, whose performance did not differ from one another. Results underscore the importance of intratest comparison measures in the interpretation of central auditory tests (American Speech-Language-Hearing Association [ASHA], 2005 ; American Academy of Audiology [AAA], 2010). Results also support the "non-modular" view of (C)APD in which cross-modal deficits would be predicted based on shared neuroanatomical substrates. Finally, this study demonstrates that auditory tests alone are sufficient to distinguish (C)APD from supra-modal disorders, with cross-modal analogs adding little if anything to the differential diagnostic process.

Speech perception in noise: Exploring the effect of linguistic context in children with and without auditory processing disorder

Objective: The objective of this study was to investigate whether the speech perception problems in noise of children with auditory processing disorder (APD) stem from an auditory or a higher order dysfunction. Design: A repeated measures design comparing the sentence key word recognition scores of children with APD and a control group was used. Four sentence lists from the Test de phrases dans le bruit (TPB) were presented with a babble masker at four different signal-to-noise ratios. The TPB is a Canadian French adaptation of the speech perception in noise test. Study Sample: Ten participants between 9–12 years with APD participated in this study, as well as ten age- and gender-matched children with no sign of APD. Results: Group analyses revealed that children with APD had poorer overall sentence key word recognition scores than the control group. Analysis of the difference scores between the high and low predictability sentences indicated that the benefit derived from linguistic context is similar between the groups. However, individual patterns of results revealed different profiles within the APD group. Conclusion: Further study using a larger sample is warranted to deepen our understanding of the nature of APD and identify characteristic profiles to enable better tailoring of therapeutic programs.SumarioObjetivo: El objetivo de este estudio fue investigar cuándo los problemas de percepción del habla en ruido, en niños con trastornos del procesamiento auditivo (APD), son producto de una disfunción auditiva o de niveles superiores. Diseño: Repetición de mediciones para comparar las puntuaciones de reconocimiento de palabras clave en una oración, entre niños con APD y los de un grupo control. Estudio: Se presentaron cuatro listas de oraciones del Test de Phrases dans le Bruit (TPB – Prueba de frases en ruido-) en presencia de balbuceo enmascarante, a cuatro diferentes relaciones señal/ruido. El TPB es una adaptación al Francés del Canadá, de la prueba de Percepción del Habla en Ruido. Muestra: Participaron en este estudio diez niños con APD entre 9-12 años y 10 niños sin signos de APD, pareados por edad y sexo. Resultados: El análisis de grupos reveló que los niños con APD tienen puntuaciones generales más pobres en el reconocimiento de palabras clave en oraciones, que los del grupo control. El análisis de las diferencias entre las puntuaciones de las oraciones de mayor o menor predictabilidad, indicaron que el beneficio que se deriva del contexto lingüístico es similar entre los dos grupos. Sin embargo, los patrones de resultados individuales, revelan diferentes perfiles en el grupo de niños con APD. Conclusiones: Se justifican estudios adicionales usando una muestra más amplia, para profundizar nuestro conocimiento sobre la naturaleza de los APD y para identificar perfiles característicos que nos permitan la mejor individualización de programas terapéuticos.

Sensitivity and specificity of auditory steady-state response testing

INTRODUCTION:The ASSR test is an electrophysiological test that evaluates, among other aspects, neural synchrony, based on the frequency or amplitude modulation of tones.OBJECTIVE:The aim of this study was to determine the sensitivity and specificity of auditory steady‐state response testing in detecting lesions and dysfunctions of the central auditory nervous system. METHODS:Seventy volunteers were divided into three groups: those with normal hearing; those with mesial temporal sclerosis; and those with central auditory processing disorder. All subjects underwent auditory steady‐state response testing of both ears at 500 Hz and 2000 Hz (frequency modulation, 46 Hz). The difference between auditory steady‐state response‐estimated thresholds and behavioral thresholds (audiometric evaluation) was calculated.RESULTS:Estimated thresholds were significantly higher in the mesial temporal sclerosis group than in the normal and central auditory processing disorder groups. In addition, the difference between auditory steady‐state response‐estimated and behavioral thresholds was greatest in the mesial temporal sclerosis group when compared to the normal group than in the central auditory processing disorder group compared to the normal group. DISCUSSION:Research focusing on central auditory nervous system (CANS) lesions has shown that individuals with CANS lesions present a greater difference between ASSR‐estimated thresholds and actual behavioral thresholds; ASSR‐estimated thresholds being significantly worse than behavioral thresholds in subjects with CANS insults. This is most likely because the disorder prevents the transmission of the sound stimulus from being in phase with the received stimulus, resulting in asynchronous transmitter release. Another possible cause of the greater difference between the ASSR‐estimated thresholds and the behavioral thresholds is impaired temporal resolution.CONCLUSIONS:The overall sensitivity of auditory steady‐state response testing was lower than its overall specificity. Although the overall specificity was high, it was lower in the central auditory processing disorder group than in the mesial temporal sclerosis group. Overall sensitivity was also lower in the central auditory processing disorder group than in the mesial temporal sclerosis group.